In guidelines on primary prevention of cardiovascular disease (CVD), the Framingham coronary heart disease (CHD) risk score has long been recommended for assessing 10-year risk of myocardial infarction (MI) or cardiac death. In 2008, the Framingham group developed the Framingham CVD risk score, which added new endpoints of angina, cerebrovascular disease, peripheral vascular disease, and heart failure to the CHD risk score. The Framingham CVD risk score has since been adopted and favored by the latest guidelines for cardiovascular risk assessment. Significant Implications of CVD Risk Little is known about the population level effects of switching from the Framingham CHD risk score to the Framingham CVD score. In the May/June 2011 Journal of Clinical Lipidology, my colleagues and I conducted a study to determine the impact of switching to the Framingham CVD score from the Framingham CHD score on the United States population. For our study, 1,020 patients from NHANES were analyzed to define the changes in risk category distribution and corresponding changes to lipid goal achievements. When the Framingham CVD risk score was used, 63% of men and 74% of women moved up by at least one risk category when compared with the Framingham CHD risk score. Additionally, the low-risk population decreased from 52% to 16%, and the high-risk population increased from 4% to 20%. “Little is known about the effect of switching from the Framingham CHD risk score to the Framingham CVD score.” In February 2011, the American Heart Association released recommendations on CVD prevention in women. It modified 10-year risk thresholds and recommended using the Framingham CVD risk model for routine risk assessment. In the updated...